Your First Year As a Nurse, Second Edition: Making the Transition from Total Novice to Successful Professional
304
Your First Year As a Nurse, Second Edition: Making the Transition from Total Novice to Successful Professional
304eBook
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Overview
Welcome to the compassionate and caring world of nursing! You are entering a profession that offers great rewards and endless opportunities. But you must prepare for the challenges ahead and do everything you can to ensure that you experience the best that nursing has to offer.
Get off to the right start in your new profession by learning how to:
• Find the job that's perfect for you
• Create your own patient-centered style of nursing
• Develop positive relationships with doctors, patients, and other nurses
• Stay positive, deal with conflict and adversity, and avoid burnout
• Network, enhance your education and career, and become a leader
And NEW! to this revised edition:
• Invaluable information about nursing licensure, including an extensive FAQ section
• Discussion of professional issues related to standards of care, nursing ethics, and
health-care reimbursement
• Job-hunting challenges and solutions
• Solutions for handling quandaries such as delayed career start, nontraditional
practice, and more
• Trends and opportunities for the future of nursing
• A special section for second-career nurses
Product Details
| ISBN-13: | 9780307591753 |
|---|---|
| Publisher: | Crown Publishing Group |
| Publication date: | 11/09/2010 |
| Sold by: | Random House |
| Format: | eBook |
| Pages: | 304 |
| File size: | 2 MB |
About the Author
Read an Excerpt
Chapter 1
Your New Career
It's your first day as a nurse and, boy, are you nervous. Did you make the right decision? Is this the right career for you? Can you handle the responsibility? The nervousness, anxiety, and indecision are normal. When the reality of your chosen profession becomes evident, it can be overwhelming. But never lose sight of the reason you chose to enter this glorious profession—to help others, make a difference, and make the world a better place to be. That's what it's all about.
Most of us start out scared, nervous, and perhaps even feeling inadequate. Remember that after the end of your first day on the new job, you'll be more experienced than you were that morning. After each day, you will be further along than you were the day before. Before you know it, days will turn into weeks, weeks into months, and finally you'll find yourself with a full year of experience under your belt!
It's important, in this early phase of your career, to set small, realistic goals for yourself. Set an initial goal to get through orientation. Then set a goal to get through your first three months, then six months, and then one year. Most experienced nurses agree that it takes about a year before you feel comfortable with most common situations. It will probably take two years to be completely comfortable with all situations. So be patient and just persevere.
In many ways, your education is just beginning. I used to say, jokingly, that I never learned anything until I got out of nursing school. Although that isn't completely accurate, when I was finally working on my own as a nurse and was out of the student mode and no longer in the safe confines of my instructor's wing, it sometimes felt like as if I were starting froms cratch. For certain, I'll never forget how overwhelmed and scared I felt the first time I was handed the narcotics keys to hold on to through my shift. I wanted to say, "Oh, you've made a mistake. I'm not responsible enough to carry these keys." I suddenly realized the responsibility I had. I wondered if I could meet everyone's expectations.
Nursing in North America
While there are some minor differences, such as incredentials and terminology, nursing in the United States and nursing in Canada are very similar. The biggest difference is that Canadian nurses work within a national health-care system and nurses in the United States work in a largely private system. This does not, however, translate into a significant difference in day-to-day practice.
Nurses in the United States are licensed by the state(s) in which they practice, and Canadian nurses are likewise licensed by the appropriate province or territory. Nurses in the United States who are involved in clinical practice should obtain their own malpractice insurance in addition to the coverage they may or may not have from their employer. With the exception of advanced practice nurses, this is a much less common practice in Canada, where the legal climate is very different. In Canada, employers often cover nurses for liability, though most have additional coverage through their provincial and national nursing associations. However, the Canadian legal climate is changing. More and more nurses are being named in lawsuits. Potential litigation is a concern for every nurse to take seriously.
Both Canada and the United States utilize nursepractitioners (NPs) and clinical nurse specialists (CNSs). Both countries alsoutilize practical nurses, although their titles may vary depending on which part of the continent they are practicing. You will find licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) in the United States. In Canada, there are registered practical nurses (RPNs), LPNs, as well as several other titles, though the trend is to use only the title LPN across the country. When nurses are licensed in Canadian provinces other than Quebec and Ontario, where membership is left to individual choice, they automatically become members of their provincial and national nurses association, the Canadian Nurses Association (CNA). In the United States, professional association memberships are completely up to each nurse.
Despite such minor differences, nurses in Canada and the United States have the same challenges, rewards, goals, frustrations, and joys.
I also remember how I would gaze at more-experienced nurses with awe. They seemed so confident, so in control, so calm in a crisis, and so all-knowing. I couldn't imagine that I would ever reach that level ofpractice.
But an amazing thing happened along the way. Not only did I continue to learn and grow in my new career, but here I am, more than twenty years later, loving every minute of this wonderful profession and giving advice to other nurses. I've come a long way from being a scared, self-conscious rookie nurse who thought that the person who gave me the narcotics keys was not thinking clearly. You, too, will someday look back and see how far you have come.
Externship Versus Internship
An externship differs from an internship. While an externship or "summer nursing associate program" is usually available to student nurses, an internship or nurse residency program is usually offered to a new RN as intensified training during his or her first year of employment and/or in preparation for working in specialty areas such as the intensive care unit (ICU), the operating room (OR), and labor and delivery (L&D).
Many externs continue to work part time at that facility until they graduate. Not only does an externship give them significant clinical and leadership skills, but the experience looks great on their resume and gives them a foot in the door for possible hire after graduation.
Internships for new RNs vary in type and scope and are different from general employee orientation. Some have been developed by the individual hospital or health system, and others are part of a nationally developed curriculum. Characteristics of internship/residency programs may include the following:
• Classroom and skills lab instruction
• Online learning opportunities
• Unit-based clinical experience with preceptor
• Mentors
• Support/self-caregroups
• "Looping" to other related units in the facility
It is in your best interest to find the longest and most comprehensive new graduate orientation/internship program available. A one-year program is ideal and very desirable. However, not every facility offers this.
In fact, you've already come a long way. Phase one of your nursing education and training was your formal schooling. Consider your first job as a nurse to be phase two.
Don't be too hard on yourself in the beginning. You're not expected to know everything as a new graduate. In fact, no one—not even the most experienced nurse, doctor, or other practitioner—knows everything. For each of us, myself included, learning is an ongoing process. If you're not learning, you're stagnating.
So now it is time to begin phase two of your learning process: your first job. Where do you start? What do you need to know? The key to getting the job you want is to have a plan, prepare, and dive in!
Preparing to Land Your First Job as a Nurse
How can you enhance your education and experiences andthus improve your chances of getting the job you want from the start? There aremany ways.
While you're still a student look for hospitals that offer externship programs. Often run during the summer months, these are programs specifically for student nurses. You will work in the clinical area with a preceptor—an experienced nurse who is assigned to work closely with you, show you the ropes, assist you in performing procedures, and make sure you learn what you need to know.
In addition, most health-care facilities offer tech positions, such as emergency department (ED) tech and electrocardiograph (ECG) tech. Many nursing students also work as nurse's aides or as patient care assistants (PCAs). As a student nurse with some additional training, you may qualify to become a licensed or certified nursing assistant (CNA). If long-term care is in your future, working as a physical therapy aide can be a great experience. Check with the nurse recruiter or human resources department in several local facilities to see what your options are.
Consider any part-time job in the health-care field that will enhance your experience, particularly if it will increase your familiarity with a facility where you might want to work after graduation. By working parttime, you will increase your contacts at that facility and have the opportunity to display your skills and demonstrate your work ethic. These types of positions will help you develop that critical sense of autonomy that you need to be successful as you work independently, rather than as a student nurse.
Learn everything you can—every day. Apply yourself. Show up for class and clinicals. Stay for pre- and post-clinical conferences. Listen to and learn from your fellow students and their patients' experiences. This is your future. Prepare, prepare, prepare. Take advantage of every learning opportunity that comes your way.
Look for opportunities to enhance your credentials and experience. Obtain cardiopulmonary resuscitation (CPR) or advanced cardiac lifesupport (ACLS) certification from the American Heart Association or its Canadian equivalent, the Heart and Stroke Foundation of Canada. Although any acute care hospital will certify you in CPR, having it before you are hired gives you a competitive edge, and with it, you will feel more secure in the clinical arena. Finally, enhancing your computer skills is a good foundation for any job.
Be sure to become active in the National Student Nurses Association (NSNA) or the Canadian Nursing Students' Association (CNSA). Each offers nursing students leadership and career development opportunities as well as tangible benefits such as malpractice and health insurance.
Attend both the state student nurse and state chapter of the American Nurses Association's (ANA) annual conventions. Be sure to dress your professional best—in a business suit or other business attire. You'll find exhibitors from various health-care facilities—prospective employers—and representatives from educational institutions, professional associations, and companies that have products and services of interest to nurses.
These professional gatherings are a great place to find out which facilities are offering externship or internship programs, what their graduate orientation program entails, what specialty areas are available at each facility, and however else they may be suited to you. You can start planning for your future at these events. It's never too soon to start making contacts and gathering information for your future. Networking—making personal contacts and connections—at events like these is the best way to land the job of your choice.
What Is the Right First Job for You?
If jobs are plentiful in your area, you can be somewhat selective about your first job. The job market is predicted to be good for nurses for the foreseeable future, but the nursing job market fluctuates just like the stock market. There will always be excesses and shortages. If jobs are scarce in your area, you may have to be less picky, but you should still evaluate carefully every job offer presented to you. (See chapter 11 for tips on finding a position in a tight job market.) It is ideal to choose a facility that offers a strong orientation program and has good educational support services in place (such as unit educators, ongoing in-service, internships, and so on). You will be building a foundation at your first job, and your first year in practice is critical.
Educate Yourself
The following are some questions you should ask anypotential employer:
• What specialties are available to new graduates?
• Do you have internship programs?
• What does your new-graduate orientation program consist of?
• Do you allow time off for seminars and continuing education?
• What type of ongoing, in-house, in-service training is available?
• Do you have unit-based educators?
• Are the educators available on all shifts?
• How long will I work with a preceptor?
What's Really Important?
While money is important, it should never be your primary consideration. When all is said and done, all the money in the world won't make up for a bad work environment or lack of support.
Benefits are also important and may be more valuable to you than the base salary. Consider what, if anything, you will have to contribute to these. Aside from the usual benefits of health and life insurance, ask about tuition reimbursement. Continuing your formal education is an important part of your professional development and ongoing career management, and considering the cost of higher education, tuition reimbursement is a precious commodity. While retirement is a long way off for some, scrutinize retirement plans, especially plans in which the employer contributes. Most facilities have printed material listing all the benefits for your position, so be sure to compare the benefits from one employer to another.
What You Need to Know About Any Job
Know exactly what you are getting into before you get into it. Always carefully read a copy of the job description, and ask the following questions:
• Will I be required to work on weekends and holidays?\
• Will I have to take call?
• How are performance evaluations done and how often?
• Will I be required to float—do shift work?
Find out the answers to these important questions beforeyou start.
You should also ask around and find out which facilities have the best reputation for nursing in your area. Ask your nursing instructors, physicians you know, and especially other nurses. Listen to your gut, too. Is it a place where you would feel comfortable working?
How to Get the Job You Want
Networking is always your best way of finding the right job. Simply put, networking is making personal contacts and connections with people in your field of interest. It's talking to people whom you already know and letting them know what you're looking for. It's also meeting and making contact with new people at career fairs and career days, professional association meetings, conventions, and facility open houses.
Making direct contact with nurse recruiters in facilities you are interested in is also a good approach. Call them; write to them; e-mail them; connect with them on Twitter, LinkedIn, and Facebook; or present yourself in person.
It's All About You
Whenever you are making face-to-face contact with a potential employer, your appearance is critical. First impressions are made in as little as three seconds, and once they are in place, they are lasting. The first impression you make, good or bad, will influence the decision of whether or not to hire you.
For job fairs, interviews, professional organization meetings, and anything else career-related, always dress sharp. A business suit is your best bet for interviewing or making initial contacts at events such as job fairs or conventions. Stick to conservative and traditional styles and colors, and minimize accessories.
In addition to a professional appearance, nurse recruiters are looking for someone who makes good eye contact, smiles, extends a hand to shake, and engages in conversation. They are impressed by someone who acts in a professional manner, is courteous and polite, and is able to interact well. Nursing is a people-oriented job. Recruiters and prospective employers are looking just as much for a personality as they are for someone's credentials. Never get complacent or cocky about your credentials. You must still prove yourself.